In a study of 50,000 patients at Veterans Affairs hospitals over 5 years, "Heart failure admission rates remained constant at about 5 per 1,000 veterans. Mortality at 30 days decreased (7.1% to 5.0%, p < 0.0001), whereas rehospitalization for heart failure at 30 days increased (5.6% to 6.1%, p = 0.11)" italics added

"analysis using Hospital Compare data conducted by the Greater New York Hospital Association also concluded that mortality is inversely related to readmissions. (Chart 3)"

Chart shows that states with lowest mortality, MA, CT, DC, DE, MN, NJ, IL, OH, MI, PA, all have above average readmissions, and all but two of these states are in the 70th percentile of readmissions or higher.

"safety-net hospitals were more likely than other hospitals to be penalized under the... Hospital Readmissions Reduction Program...

"[M]ortality outcomes in safety-net hospitals were better than those in other hospitals for patients with acute myocardial infarction, heart failure, or pneumonia.

"Third, the adjusted cost per Medicare discharge was virtually identical at safety-net and non-safety-net hospitals.

"Taken together, these results indicate that safety-net hospitals provided better health outcomes than other hospitals at a similar cost level yet were more likely to be penalized under programs that are intended to improve and reward high performance."

"We found that large hospitals, teaching hospitals, and SNHs [safety net hospitals] are more likely to receive payment cuts under the HRRP [readmissions penalties]. It is unclear exactly why these hospitals have higher readmission rates than their smaller, nonteaching, non-SNH counterparts, but prior research suggests that differences between hospitals are likely related to both case mix (medical complexity) and socioeconomic mix of the patient population.2-3 There is less evidence that differences in readmissions are related to measured hospital quality.6"

Interviews

Dr Ashish Jha, of Harvard's School of Public Health, told PBS, "If you look at, for instance, the U.S. News [and World Report] publishes its list of top 50 hospitals. Those hospitals tend to have very low infection rates, very low mortality rates, very low death rates. Guess what? They tend to have very high readmission rates, because they do such a good job of keeping their patients alive that many of them are readmitted."

Dr. Sunil Kripalani, of Vanderbilt University Medical Center told Fox News, "Among patients with heart failure, hospitals that have higher readmission rates actually have lower mortality rates. So, which would we rather have -- a hospital readmission or a death?"